Provider Demographics
NPI:1508243809
Name:SHEARER, IAN DAVID (BUSINESS OWNER)
Entity Type:Individual
Prefix:MR
First Name:IAN
Middle Name:DAVID
Last Name:SHEARER
Suffix:
Gender:M
Credentials:BUSINESS OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1082 ALBANY CT
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-4814
Mailing Address - Country:US
Mailing Address - Phone:239-285-0580
Mailing Address - Fax:
Practice Address - Street 1:1082 ALBANY CT
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-4814
Practice Address - Country:US
Practice Address - Phone:239-285-0580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL14000133728171WV0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WV0202XOther Service ProvidersContractorVehicle Modifications